螺旋管式小肠镜临床应用价值初探  

Spiral enteroscopy in diagnosis and managements of small bowel diseases

作　　者：李晓波[1] 宋燕[1] 戴军[1] 高云杰[1] 戈之铮[1] 

机构地区：[1]上海交通大学医学院附属仁济医院消化内科上海市消化疾病研究所,200001

出　　处：《中华消化内镜杂志》2010年第1期9-11,共3页Chinese Journal of Digestive Endoscopy

基　　金：上海市重点学科建设资助项目（Y0205）

摘　　要：目的初步评估螺旋管式小肠镜在小肠疾病诊治中的应用价值。方法对2009年7月至9月间采用经口螺旋管式小肠镜诊治的8例患者的临床资料进行总结分析，包括内镜插入深度、检查时间、并发症发生情况以及活检与治疗结果等。结果2例诊断为小肠克罗恩病，活检病理提示为活动性炎症和肉芽组织；1例诊断为小肠肿瘤，活检病理提示为高级别上皮内瘤变；1例检出空肠溃疡；1例检出空肠术后吻合口及空回肠多发息肉，并行息肉氩离子凝固术（APC）治疗；3例未发现明显异常。螺旋管式小肠镜均成功插至屈氏韧带处，最深至屈氏韧带下3．6m处，平均插入深度为屈氏韧带下2．2m；检查时间为25～77min，平均41min。术中操作与气囊式内镜相同，APC治疗未遇任何困难。未发生相关并发症。结论螺旋管式小肠镜操作简便、安全，进镜速度快，具有较高的临床应用价值。Objective To evaluate the use of spiral enteroscopy in diagnosis and treatment of small-bowel diseases. Methods The data of 8 patients who underwent spiral enteroseopy from July to September 2009 were retrospectively studied. The variables including maximal insertion depth, total procedure time, complications, and outcome were evaluated. Results The average maximal depth of intubation was 2. 2 m beyond the Ligament of Triez （0-3. 6 m beyond Ligament of Triez）, with a mean procedure time at 41 min （25 to 77 min）. Small bowel Crohn＇s disease was diagnosed in 2 eases with biopsy suggesting active inflammation and granular formation. Small intestinal tumor was detected in 1 patient with pathological finding of high grade dysplasia. Jejunal ulcer was detected in 1 patient. Multiple polyps were found in 1 patient after jejunal anastomosis, which were then treated with endoscopic argon plasma coagulation （APC）. No abnormalities were found in 3 other patients. No complications occurred during and after the procedure. The maneuver of spiral enteroscopy and APC were same as that of balloon enteroscopy. Conclusion Spiral enteroscopy is simple and convenient to operate, which is of great potential in clinical use.

关 键 词：内窥镜 螺旋管式小肠镜 小肠疾病 

分 类 号：R574[医药卫生—消化系统]